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Brown TG, Moxley-Kelly N, Ouimet MC. Recidivism prevention for impaired driving: Longitudinal 5-year outcomes from Quebec's severity-based intervention assignment program. J Subst Abuse Treat 2022; 142:108855. [PMID: 35988514 DOI: 10.1016/j.jsat.2022.108855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 06/09/2022] [Accepted: 08/03/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Driving while impaired by alcohol (DWI) is a persistent problem. Tailoring intervention modality to client risk and needs (i.e., risk/needs) is posited to both reduce recidivism more efficiently than uniform approaches and circumvent overtreatment or undertreatment. DWI drivers in Quebec must participate in a severity-based intervention assignment program to be relicensed, but like most tailoring programs it has yet to undergo systematic scrutiny. The current longitudinal cohort study tests two main hypotheses underpinning this approach: 1) drivers classified at higher recidivism risk based on their arrest characteristics (DWIR) show poorer outcomes over up to 5-years postassessment compared to drivers classified at lower risk (DWIF); and 2) for both DWIR and DWIF groups, assignment of drivers with greater risk/needs to intensive intervention (II) will be advantageous for reducing recidivism risk compared to assignment into brief intervention (BI) for those with lower risk/needs. METHODS Drivers who entered the program from 2012 to 2016 were followed to the end of 2018 (N = 37,612). Survival analysis examined the predictive validity of the initial classification into DWIR or DWIF groups for documented recidivism over a follow-up of up to 5 years. Logistic regression discontinuity evaluated the relative outcomes of drivers who were assigned to either BI or II. The study explored interaction effects between classification and intervention assignment with age and sex. RESULTS In line with the hypothesis, the average hazard of recidivism was 58 % greater in DWIR drivers compared to DWIF drivers. In both DWIF and DWIR drivers, assignment of drivers with greater risk/needs to II was associated with reduced recidivism compared to assignment of drivers with lower risk/needs to BI, with 57 % and 35 % decreased probability of recidivism, respectively. Younger age was more strongly associated with recidivism risk in DWIF drivers than in DWIR drivers. CONCLUSIONS The current study found that Quebec's severity-based intervention assignment approach accurately identifies DWI drivers who: i) by their arrest characteristics pose a greater risk for recidivism, which may require expeditious exposure to preventative countermeasures; and ii) as a function of their greater risk/needs, benefit from assignment to more intensive intervention to mitigate their recidivism risk.
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Affiliation(s)
- Thomas G Brown
- Université de Sherbrooke, Longueuil, QC, Canada; McGill University, Montreal, QC, Canada; Douglas Hospital Research Centre, Verdun, QC, Canada
| | - Nathaniel Moxley-Kelly
- McGill University, Montreal, QC, Canada; Douglas Hospital Research Centre, Verdun, QC, Canada
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Cigarette Smoking as a Predictor of Male DUI Recidivism. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010761. [PMID: 34682508 PMCID: PMC8535916 DOI: 10.3390/ijerph182010761] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/03/2021] [Accepted: 10/08/2021] [Indexed: 11/17/2022]
Abstract
This study aimed to investigate the predictors of recidivism in first-time driving under the influence (DUI) offenders, analyzing variables derived from medico-legal and toxicological examinations. The research was structured as a comparative study for the period 2012-2019. DUI offenders with a blood alcohol concentration >0.5 were included in the study. The case group consisted of recidivist offenders, while the comparison group consisted of first-time offenders. Personal data, socioeconomics, and parameters linked to the DUI were compared between the two groups. Significance was determined by chi-square and Mann-Whitney tests. To prevent confounding effects, multivariate binary logistic regression analysis was performed. Our sample encompassed 1678 subjects (196 in the case group, 1482 in the comparison group). Gender, driving license category, education, and tobacco use resulted in significant differences between the groups. In a model including age at DUI, education, and smoking habit as independent variables, higher educational levels (high school, bachelor's) and older age protected against recidivism, whereas smoking >20 cigarettes/day was an independent risk factor for recidivism. Recidivist offenders have specific characteristics indicating different therapeutic programs and carefulness in driving license regranting. A higher tobacco consumption in recidivists suggests that the use of this substance could influence the risk of DUI for reasons that will need to be explored.
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Kuo YC, Chen LY, Chang HM, Yang TW, Huang MC, Cheng WJ. Different demographic and drinking profiles of motorcyclists and car drivers with the first-time offense of driving/riding under the influence of alcohol. ACCIDENT; ANALYSIS AND PREVENTION 2020; 134:105330. [PMID: 31678785 DOI: 10.1016/j.aap.2019.105330] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 09/10/2019] [Accepted: 10/15/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Driving/riding under the influence (DUI) of alcohol is a major public concern worldwide. Only a few studies have distinguished DUI-related variables between motorcyclists and car drivers. This study examined the differences in demographic characteristics and drinking behaviors among first-time DUI offenders operating different transportation vehicles, and risk factors for frequent DUI (fDUI) among them. METHODS We conducted an anonymous survey for 561 first-time DUI offenders who attended a mandatory educational program. Participants self-administered questionnaires concerning alcohol drinking behaviors and DUI. We defined fDUI as at least two DUI behaviors per month based on self-reported information. Demographic and drinking characteristics were compared between DUI offenders, car drivers and motorcyclists. Logistic regression analysis was used to examine risk factors for fDUI. RESULTS Two-thirds of first-time DUI offenders were motorcyclists. Compared with car drivers, motorcyclists were younger and less educated, with a higher percentage of them being women and unmarried. Car drivers reported a higher rate of fDUI than motorcyclists (16.5% vs. 9.7%). Regression analysis revealed that binge drinkers had a higher fDUI risk in both groups. Regarding the drinking place prior to DUI behavior, workplace was significantly associated with fDUI in car drivers. CONCLUSIONS Distinct strategies may be required for motorcyclists and car drivers for DUI recidivism prevention, and drinking place interventions should also be considered.
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Affiliation(s)
- Yen-Chun Kuo
- Linsen Chinese Medicine and Kunming Branch, Taipei City Hospital, Taipei, Taiwan
| | - Lian-Yu Chen
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan; Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
| | - Hu-Ming Chang
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Tien-Wei Yang
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Ming-Chyi Huang
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Wan-Ju Cheng
- Department of Psychiatry, China Medical University Hospital, Taichung, Taiwan; Department of Public Health, China Medical University, Taichung, Taiwan.
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Courchesne NS, Muth CM, Barker M, Woodruff SI. Correlates of Breath Alcohol Concentration Among Driving Under the Influence Program Clients in Southern California. JOURNAL OF DRUG ISSUES 2018. [DOI: 10.1177/0022042618815688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Understanding factors correlated with breath alcohol concentration (BrAC) at time of arrest for driving under the influence (DUI) may lead to informed rehabilitation programs. This study describes correlations between BrAC at time of arrest and sociodemographic, mental, and physical health, and alcohol-related characteristics among clients in a large California DUI Program. Client reported data ( n = 17,282) were collected at an intake from 2009 to 2014. BrACs ranged from 0.083% to 0.390%, with an average of 0.159% ( SD = 0.051), almost twice the legal limit in the state. Approximately 10.6% of the variance in BrAC was explained by 11 significant correlates. Two sociodemographic factors (age and race/ethnicity) as well as several alcohol-related characteristics were related to higher BrAC levels, whereas comorbid mental and physical health factors played less of a role. Factors associated with BrAC are complex and warrant further investigation to identify causality and inform future interventions.
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Gibson S, Woodford M, Czeizinger TJ. Avoiding the Last Ride: Can DUI Programming Address Multiple Risk Factors to Reduce Recidivism? JOURNAL OF ADDICTIONS & OFFENDER COUNSELING 2018. [DOI: 10.1002/jaoc.12047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Sandy Gibson
- Department of Counselor Education, The College of New Jersey
| | - Mark Woodford
- Department of Counselor Education, The College of New Jersey
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Wickens CM, Flam-Zalcman R, Mann RE, Stoduto G, Docherty C, Thomas RK. Characteristics and predictors of recidivist drink-drivers. TRAFFIC INJURY PREVENTION 2016; 17:564-572. [PMID: 26761189 DOI: 10.1080/15389588.2015.1125477] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 11/24/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE The current study compared characteristics of nonrecidivist versus recidivist drink-drivers and of recidivists in their first versus second appearance at Back on Track (BOT), the remedial measures program for impaired drivers in Ontario, Canada. METHODS Information from 59,134 convicted drivers who participated in BOT between 2000 and 2010 was examined to identify drivers who completed the program a second time following reconviction. RESULTS A total of 586 recidivists were identified. Compared to nonrecidivist drivers, recidivists at first attendance were more likely to be male and had higher scores on measures of alcohol dependence and adverse legal consequences of substance use. Compared to nonrecidivist drivers, recidivists at second attendance were significantly older, had a higher income, were more likely to be retired, and were less likely to be employed part-time. They had fewer legal problems. Recidivists reported fewer drinking days and fewer drinks per occasion but greater use of benzodiazepines than nonrecidivists and had higher scores on a measure of future risk of alcohol- and drug-related problems. Comparison of recidivists' characteristics at first versus second attendance confirmed many of these findings, with second-time recidivists reporting fewer drinks per drinking day and greater use of benzodiazepines and having higher scores on a measure of future substance use problems than first-time recidivists. CONCLUSIONS Results suggest that identification of drivers at increased risk of recidivism may be possible at first program attendance by examining indicators of increased alcohol-related problems. In addition, recidivists appear to show a greater readiness to change at second attendance. Implications for remedial program development and recommendations for future research are discussed.
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Affiliation(s)
- Christine M Wickens
- a Centre for Addiction and Mental Health , Toronto , Ontario , Canada
- b Dalla Lana School of Public Health, University of Toronto , Toronto , Ontario , Canada
| | | | - Robert E Mann
- a Centre for Addiction and Mental Health , Toronto , Ontario , Canada
- b Dalla Lana School of Public Health, University of Toronto , Toronto , Ontario , Canada
| | - Gina Stoduto
- a Centre for Addiction and Mental Health , Toronto , Ontario , Canada
| | - Chloe Docherty
- a Centre for Addiction and Mental Health , Toronto , Ontario , Canada
| | - Rita K Thomas
- a Centre for Addiction and Mental Health , Toronto , Ontario , Canada
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Robertson A, Gardner S, Walker CS, Tatch A. DUI recidivism by intervention adherence: a multiple risk factor approach. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2016; 42:597-605. [DOI: 10.3109/00952990.2016.1167898] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Angela Robertson
- Social Science Research Center, Mississippi State University, Starkville, MS, USA
| | - Sheena Gardner
- Social Science Research Center, Mississippi State University, Starkville, MS, USA
| | - Courtney S. Walker
- Social Science Research Center, Mississippi State University, Starkville, MS, USA
| | - Andrew Tatch
- Social Science Research Center, Mississippi State University, Starkville, MS, USA
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Green RS, Kureshi N, Erdogan M. Legal consequences for alcohol-impaired drivers injured in motor vehicle collisions: A systematic review. ACCIDENT; ANALYSIS AND PREVENTION 2015; 80:106-116. [PMID: 25899058 DOI: 10.1016/j.aap.2015.04.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 04/01/2015] [Accepted: 04/06/2015] [Indexed: 06/04/2023]
Abstract
The treatment of alcohol-impaired drivers injured in a motor vehicle collision (MVC) is a complex public health issue. We conducted a systematic review to describe the legal consequences for alcohol-impaired drivers injured in a MVC and taken to a hospital or trauma center. Methods We searched MEDLINE, Embase, and CINAHL databases from inception until August 2014. We included studies that reported legal consequences including charges or convictions of injured drivers taken to a hospital or trauma center after a MVC with a blood alcohol concentration (BAC) exceeding the legal limit.Results Twenty-six studies met inclusion criteria; twenty studies were conducted in the USA, five in Canada, and one in Sweden. All were cohort studies (23 retrospective, 3 prospective) and included 11,409 patients overall. A total of 5,127 drivers had a BAC exceeding the legal limit, with legal consequences reported in 4937 cases. The median overall DUI/DWI conviction rate was 13% (range 0-85%). The median percentage of drivers with a previous conviction on their record for driving under the influence (DUI) or driving while intoxicated (DWI) was 15.5% (range 6-40%). The median percentage of drivers convicted again for DUI/DWI during the study period was 3.5% (range 2-10%). Heterogeneity between study designs, legal jurisdictions, institutional procedures and policies for obtaining a legally admissible BAC measurement precluded a meta-analysis. Conclusions The majority of intoxicated drivers injured in MVCs and seen in the emergency department are never charged or convicted. A substantial proportion of injured intoxicated drivers had more than one conviction for DUI/DWI on their police record.
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Affiliation(s)
- Robert S Green
- Department of Critical Care Medicine, Dalhousie University, Halifax, NS, Canada; Department of Emergency Medicine, Dalhousie University, Halifax, NS, Canada; Trauma Nova Scotia, Halifax, NS, Canada.
| | - Nelofar Kureshi
- Division of Neurosurgery, Dalhousie University, Halifax, NS, Canada.
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Miller PG, Curtis A, Sønderlund A, Day A, Droste N. Effectiveness of interventions for convicted DUI offenders in reducing recidivism: a systematic review of the peer-reviewed scientific literature. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2014; 41:16-29. [PMID: 25321949 DOI: 10.3109/00952990.2014.966199] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Driving under the influence (DUI) is a major cause of death and disability. Although a broad array of programs designed to curb DUI incidents are currently offered to both first-time and recidivist DUI offenders, existing evaluations of the effectiveness of these programs have reported mixed results. OBJECTIVE To synthesize the results of DUI program evaluations and determine the strength of the available evidence for reducing recidivism for different types of programs. METHODS A systematic review of all EBSCO databases, EMBASE, PubMed, ProQuest, Sociological Abstracts and TRIS was conducted to identify evaluations of treatments/interventions to prevent DUI offenses. Additional articles were identified from reference lists of relevant articles. RESULTS A total of 42 relevant studies were identified by the search strategy. Of these, 33 utilized non-experimental evaluation designs or reported insufficient data to allow effect sizes to be calculated, making meta-analysis unfeasible. Evaluations of several different program types reported evidence of some level of effectiveness. CONCLUSION Because of the general lack of high quality evidence assessing the effectiveness of DUI prevention programs, it is not possible to make conclusive statements about the types of programs that are likely to be most effective. Nonetheless, there was some evidence to support the effectiveness of programs that utilize intensive supervision and education. There is a need for future evaluations to adopt more scientifically rigorous research designs to establish the effects of these programs.
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Affiliation(s)
- Peter G Miller
- School of Psychology, Faculty of Health, Deakin University , Geelong, Victoria , Australia and
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Hallstone M. The Criminal History of Repeat DUI Offenders. ALCOHOLISM TREATMENT QUARTERLY 2013. [DOI: 10.1080/07347324.2013.800390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Lapham SC, Todd M. Do deterrence and social-control theories predict driving after drinking 15 years after a DWI conviction? ACCIDENT; ANALYSIS AND PREVENTION 2012; 45:142-151. [PMID: 22269495 PMCID: PMC3323116 DOI: 10.1016/j.aap.2011.12.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Revised: 12/08/2011] [Accepted: 12/13/2011] [Indexed: 05/31/2023]
Abstract
OBJECTIVE This study investigates the utility of deterrence and social-control theories for prospective prediction of driving-while-impaired (DWI) outcomes of first-time DWI offenders. METHOD The sample consisted of a subset of 544 convicted first-time DWI offenders (N=337 females) who were interviewed 5 and 15 years after referral to a Screening Program in Bernalillo County, New Mexico. Variables collected at the 5-year (initial) interview were used in structural equation models to predict past 3-months, self-reported DWI at the 15-year follow-up (follow-up) interview. These variables represented domains defined by deterrence and social-control theories of DWI behavior, with one model corresponding to deterrence theory and one to social-control theory. RESULTS Both models fit the data. DWI jail time was positively related to perceived enforcement, which was negatively but not significantly related to self-reported DWI. Neither jail time for DWI nor perceived likelihood of arrest was linearly related to self-reported DWI at follow-up. Interactions between jail time and prior DWI behavior indicated relatively weaker associations between initial and 15-year DWI for those reporting more jail time. CONCLUSION Our prospective study demonstrated that for this convicted DWI offender cohort, classic formulations of deterrence and social-control theories did not account for DWI. However, results suggest that punishment may decrease the likelihood of DWI recidivism.
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Affiliation(s)
- Sandra C. Lapham
- Pacific Institute for Research and Evaluation, 612 Encino Place NE, Albuquerque, NM 87102, United States,
| | - Michael Todd
- Pacific Institute for Research and Evaluation, 1995 University Avenue, Suite 450, Berkeley, CA 94704, United States,
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Rauch WJ, Zador PL, Ahlin EM, Howard JM, Frissell KC, Duncan GD. Risk of alcohol-impaired driving recidivism among first offenders and multiple offenders. Am J Public Health 2010; 100:919-24. [PMID: 19846687 PMCID: PMC2853607 DOI: 10.2105/ajph.2008.154575] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2009] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We sought to determine the statewide impact of having prior alcohol-impaired driving violations of any type on the rate of first occurrence or recidivism among drivers with 0, 1, 2, or 3 or more prior violations in Maryland. METHODS We analyzed more than 100 million driver records from 1973 to 2004 and classified all Maryland drivers into 4 groups: those with 0, 1, 2, or 3 or more prior violations. The violation rates for approximately 21 million drivers in these 4 groups were compared for the study period 1999 to 2004. RESULTS On average, there were 3.4, 24.3, 35.9, and 50.8 violations per 1000 drivers a year among those with 0, 1, 2, or 3 or more priors, respectively. The relative risks for men compared with women among these groups of drivers were 3.8, 1.2, 1.0, and 1.0, respectively. CONCLUSIONS The recidivism rate among first offenders more closely resembles that of second offenders than of nonoffenders. Men and women are at equal risk of recidivating once they have had a first violation documented. Any alcohol-impaired driving violation, not just convictions, is a marker for future recidivism.
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Affiliation(s)
- William J Rauch
- Association for Unmanned Vehicle Systems International (AUVSI), 2700 South Quincy Street, Suite 400, Arlington, VA 22206, USA.
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Impinen A, Rahkonen O, Karjalainen K, Lintonen T, Lillsunde P, Ostamo A. Substance use as a predictor of driving under the influence (DUI) rearrests. a 15-year retrospective study. TRAFFIC INJURY PREVENTION 2009; 10:220-226. [PMID: 19452362 DOI: 10.1080/15389580902822725] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND Recidivism is a major problem in the prevention of DUI offenses. It is suggested that impairing substances used by drivers may relate to a higher risk of recidivism. This study aims to determine rearrest rates in different groups of arrested drivers focusing on different substances found in the blood. MATERIAL AND METHODS The data utilized were obtained from the register of suspected DUI offenders maintained by the Finnish National Institute for Health and Welfare (THL). Data were available for the 15-year period between 1993 and 2007. The number of rearrests was traced from the individuals' ID codes. The mean blood alcohol concentration (BAC) of the DUI offenders was studied as well as their age at the time of the first arrest. Rearrest rates according to alcohol and drug findings were estimated using survival analysis methods. RESULTS At the time of the first arrest, the drivers with a single DUI arrest were older and had a lower BAC than those who had a later arrest. The proportion of female drivers decreased as the number of rearrests increased. Drivers with drugs only or a combination of drugs and alcohol had a significantly higher rearrest rate than drivers with alcohol alone. Drivers with amphetamines only had the highest rearrest rates. Findings of benzodiazepine and opioids alone did not increase the risk of rearrest in the long run. Young age, male sex, high blood alcohol level, and arrest during the nighttime and during weekdays constituted a higher risk for rearrest. CONCLUSIONS A third of those suspected of driving under the influence of alcohol and/or drugs are rearrested within 15 years. Drugs, especially amphetamines, are a risk factor for faster rearrest. These results show that the groups at risk of recidivism can be pinpointed. Interventions to prevent recidivism should be developed particularly for drugged drivers. Substance abuse beginning in adolescence seems to be a greater risk.
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Affiliation(s)
- Antti Impinen
- National Institute for Health and Welfare, Helsinki, Finland.
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Fu H. Identifying repeat DUI crash factors using state crash records. ACCIDENT; ANALYSIS AND PREVENTION 2008; 40:2037-2042. [PMID: 19068312 DOI: 10.1016/j.aap.2008.08.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2008] [Revised: 07/29/2008] [Accepted: 08/14/2008] [Indexed: 05/27/2023]
Abstract
The objective of this study is to identify high risk factors that are closely related to repeat DUI crashes using readily available information from the state crash records. Survival analysis was used and a Cox proportional hazards model was developed using the police-reported crash records in the state of Louisiana. A variety of variables were found to be significant in predicting repeat DUI crashes. The factors included the characteristics of the drivers (gender, race, and age), the types of the vehicle (light truck/pick up truck or other), the characteristics of the crash (hit-and-run, driver violations, and whether the driver is arrested), the type of location (residential area or other), and the characteristics of the roadway (highway type and roadway type). This study provides a comprehensive picture of the repeat DUI crashes. The model can quantitatively predict the relative hazards of repeat DUI crashes. It can be used to identify the characteristics of the crash-involved DUI drivers who are at greatest risk of being involved in a subsequent DUI crash, allowing to apply appropriate remedial measures to reduce the risk.
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Affiliation(s)
- Haoqiang Fu
- Louisiana Transportation Research Center, Louisiana State University, Baton Rouge, LA 70808, USA.
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Holmgren A, Holmgren P, Kugelberg FC, Jones AW, Ahlner J. High re-arrest rates among drug-impaired drivers despite zero-tolerance legislation. ACCIDENT; ANALYSIS AND PREVENTION 2008; 40:534-540. [PMID: 18329404 DOI: 10.1016/j.aap.2007.08.009] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2007] [Revised: 07/04/2007] [Accepted: 08/20/2007] [Indexed: 05/26/2023]
Abstract
BACKGROUND A zero-tolerance law for driving under the influence of drugs (DUID) in Sweden led to a 10-fold increase in the number of cases submitted by the police for toxicological analysis. The statutory blood-alcohol concentration (BAC) limit for driving is 0.2 mg/g ( approximately 0.02 g%). METHODS An in-house database (TOXBASE) was used to investigate re-arrests for impaired driving over 4 years (2001-2004), which comprised 36,799 cases. The age, gender, re-arrest rate of the offenders and the concentrations of ethanol and amphetamine in blood samples were evaluated. RESULTS We found that 44% of individuals (N=16,277) re-offended 3.2 times on average (range 1-23 arrests). Between 85 and 89% of first-time offenders were men and there was also a male dominance among the recidivists (88-93%). The mean age of drunken drivers was approximately 40 years compared with approximately 35 years for driving under the influence of amphetamine, which was the drug identified in 50-60% of DUID cases, either alone or together with other licit or illicit drugs. The median BAC was 1.5mg/g ( approximately 0.15 g%), which suggests a dominance of heavy drinkers. The median BAC was even higher in recidivists (1.6-1.7 mg/g). The median concentration of amphetamine in blood was 1.0 mg/L in recidivists compared with 0.5mg/L in the first-time offenders. About 14% of drunken drivers re-offended 1-10 times compared with 68% of DUID suspects, who were re-arrested 1-23 times. People with only a scheduled prescription drug in blood were re-arrested much less frequently ( approximately 17%) compared with those taking illicit drugs (68%). CONCLUSIONS The appreciable increase in number of arrests for DUID after a zero-tolerance law might reflect a heightened enthusiasm by the police authorities armed with knowledge that a prosecution is easier to obtain. Zero-tolerance laws do not deter people from impaired driving judging by the high re-arrest rates. During the sentencing of hardcore offenders, the courts should give more consideration to the underlying substance abuse problem.
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Affiliation(s)
- Anita Holmgren
- Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Artillerigatan 12, SE-581 33 Linköping, Sweden
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Dai Q, Pruett SB. Ethanol suppresses LPS-induced Toll-like receptor 4 clustering, reorganization of the actin cytoskeleton, and associated TNF-alpha production. Alcohol Clin Exp Res 2006; 30:1436-44. [PMID: 16899048 DOI: 10.1111/j.1530-0277.2006.00172.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Ethanol (EtOH) suppresses cytokine responses induced through most Toll-like receptors (TLRs), but the mechanism of action is unclear. We recently found that acute EtOH alters lipopolysaccharide (LPS)-induced partitioning of CD14, a critical component of the LPS receptor complex, within lipid raft fractions in the macrophage-like cell line RAW264.7. METHODS Here we investigated the role of receptor clustering in alteration of the responses of cells to LPS caused by EtOH both in vitro and in vivo. The cellular distribution of CD14, TLR4, actin cytoskeleton, and tumor necrosis factor-alpha (TNF-alpha) were studied by confocal microscopy following exposure of cells to LPS with or without EtOH. TLR4 and CD14 were clustered into highly colocalized patches on the cell membrane accompanied by the reorganization of the actin cytoskeleton in some of the RAW264.7 cells as well as peritoneal cells following LPS treatment. RESULTS Addition of EtOH reduced the number of cells that had LPS-induced receptor patches and in which this reorganization occurred. Cells on which CD14 and TLR4 formed clusters or caps had substantially higher levels of membrane-bound TNF-alpha compared with cells without clustering or capping of these molecules. Interference with the actin cytoskeleton by cytochalasin D suppressed the production of TNF-alpha and receptor clustering, as EtOH did. CONCLUSIONS These data confirm our previous observations, suggest a novel mechanism of EtOH action that involves interference with receptor clustering, and indicate a potential role of actin filaments in the formation of receptor patches, subsequent activation of macrophages by LPS, and production of TNF-alpha.
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Affiliation(s)
- Qun Dai
- Department of Cellular Biology and Anatomy, Louisiana State University Health Sciences Center, Shreveport, Louisiana 71130-3932, USA
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Abstract
Driving under the influence (DUI) is a major public health problem. In 2003, there were 17,401 alcohol-related crash fatalities. Although there has been a large decrease in the fatality rates over the past two decades, further progress has stalled in recent years. This plateau in the injury and death rates resulting from impaired driving has been attributed, in part, to the persistent or repeat DUI offender. Broadly defined, repeat offenders are those individuals who, following an initial DUI arrest, relapse to driving under the influence of alcohol and other drugs. In this paper, we first provide a brief overview of several models of DUI relapse. We then review the empirical literature on DUI relapse, the data describing characteristics of first-time and repeat DUI offenders, and, especially, studies that have evaluated the impact of legal sanctions and rehabilitation programs on subsequent DUI behavior. The data reveal that DUI offenders are a heterogeneous group, and that simple models relying on only one or two behavioral domains (e.g., driving characteristics, demographics) to explain DUI relapse are insufficient to account for the DUI behavior of offenders. To advance our understanding of DUI relapse, we argue for development and testing of multifactorial models focusing on the interplay of legal, social and psychological factors that describe and explain relapse among DUI offenders. By recognizing the heterogeneity within the offender population it will be easier for researchers and clinicians to identify subgroups that are at high-risk for relapse and which should be targeted by prevention and intervention programs.
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Affiliation(s)
- Thomas H Nochajski
- School of Social Work, University at Buffalo, 660 Baldy Hall, Amherst, NY 14260, United States.
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Schermer CR, Moyers TB, Miller WR, Bloomfield LA. Trauma Center Brief Interventions for Alcohol Disorders Decrease Subsequent Driving Under the Influence Arrests. ACTA ACUST UNITED AC 2006; 60:29-34. [PMID: 16456433 DOI: 10.1097/01.ta.0000199420.12322.5d] [Citation(s) in RCA: 117] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND A substantial number of trauma center admissions are related to driving under the influence (DUI); however, there has been no prior report of brief intervention (BI) after injury reducing subsequent DUI arrests. The hypothesis of this study was that injured patients receiving BI would have a lower risk of DUI arrest within 3 years of discharge than those receiving standard care (SC). METHODS This prospective, randomized clinical trial randomly allocated patients involved in motor vehicle collisions to receive SC or a BI regarding alcohol use. The primary outcome measure was DUI arrest within 3 years of hospital discharge. DUI arrests were documented by matching demographic information to state traffic safety data. RESULTS After randomization (N = 126), BI and SC groups were similar in age, prior DUI arrests, and alcohol screening score. BI sessions lasted an average of 30 minutes and were performed by either a social worker or a trauma surgeon. Approximately one in six participants (n = 21, 16.7%) had a DUI arrest within 3 years of hospital discharge. Within 3 years of hospital discharge, 14 of 64 patients (21.9%) in the SC group had an arrest for DUI compared with only 7 of 62 patients (11.3%) who received the BI. Multivariate analysis demonstrated that BI was the strongest protective factor against DUI arrest (odds ratio [OR], 0.32; 95% confidence interval < or =CI], 0.11-0.96). Prior number of DUIs (OR, 1.43; 95% CI, 1.03-2.01) and age (OR, 0.94; 95% CI, 0.88-0.99) were also associated with DUI arrest post-hospitalization, but alcohol screening score (OR, 1.06; 95% CI, 0.99-1.13) was not. The absolute risk reduction implies that only nine patients would need to receive a BI to prevent one DUI arrest. CONCLUSION Patients who receive BI during a trauma center admission are less likely to be arrested for DUI within 3 years of discharge. BI represents a viable intervention to reduce DUI after trauma center admission.
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Affiliation(s)
- Carol R Schermer
- Department of Surgery, University of North Carolina, Chapel Hill, NC 27599, USA.
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Barclay DC, Hallbergson AF, Montague JR, Mudd LM. Reversal of ethanol toxicity in embryonic neurons with growth factors and estrogen. Brain Res Bull 2005; 67:459-65. [PMID: 16216694 DOI: 10.1016/j.brainresbull.2005.07.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2005] [Accepted: 07/04/2005] [Indexed: 11/25/2022]
Abstract
Prenatal exposure to ethanol is the cause of fetal alcohol syndrome, which is characterized by brain abnormalities and decreased mental capacity. In the current study, cultured neurons from embryonic rat cortices were used to study the reversal of ethanol toxicity on neuronal survival and neurite outgrowth. Ethanol treatment followed by treatment with estrogen and certain growth factors were used to assess the potential of these growth factors and estrogen to reverse the effects of ethanol damage. Cortical neurons from embryonic day (E) 16 rats were grown in defined medium with a glial plane at a distance of 1mm from the neurons. Ethanol (45 mM) was administered on day in vitro 1 (DIV 1) and DIV 4. Insulin-like growth factor-I (IGF-I, 10 ng/ml), insulin-like growth factor-II (IGF-II, 10 ng/ml), basic fibroblast growth factor (bFGF, 5 ng/ml), nerve growth factor (NGF, 100 ng/ml), and estrogen (Es, 10 ng/ml) were administered on DIV 4 and DIV 5. Cell viability was determined on DIV 6 using the intravital dyes fluorescein diacetate and propidium iodide. IGF-I and bFGF reduced ethanol's toxic effect on neuronal survival. Estrogen, bFGF, and NGF increased total neurite length after ethanol treatment. Although none of the treatments had a statistically significant effect on the mean number of primary neurites, all caused a statistically significant increase in the mean number of secondary neurites per cell (a measure of neuritic branching) relative to the ethanol treatment alone.
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Schermer CR, Apodaca TR, Albrecht RM, Lu SW, Demarest GB. Intoxicated motor vehicle passengers warrant screening and treatment similar to intoxicated drivers. THE JOURNAL OF TRAUMA 2001; 51:1083-6. [PMID: 11740257 DOI: 10.1097/00005373-200112000-00011] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Alcohol interventions decrease alcohol consumption and recurrent injury. The study hypotheses are (1) intoxicated passengers are similar to intoxicated drivers in crashes and driving under the influence of alcohol (DUI), and (2) DUI conviction rates after injury are low. METHODS Intoxicated motor vehicle occupants hospitalized for injury in 1996-1998 were matched to the state traffic database for crashes and DUI. Drivers and passengers were compared for crashes and DUI in the 2 years preceding and 1 year after admission. Driver DUI citation at the time of admission was also recorded. A logistic regression model for crash and DUI probability was constructed. RESULTS Six hundred seventy-four patients met inclusion criteria. In the 2 years preceding admission, passengers and drivers were equally cited for crashes (14.7% vs 19.3%, p = 0.12). In 1 year after admission, they were also equally cited (7.1% vs 7.7%, p = 0.92). Driver/passenger status was not a predictor by logistic regression; 13.4% of intoxicated drivers were convicted of DUI for the admitting crash. CONCLUSION Intoxicated passengers and drivers are equally likely to be cited for crashes and DUI before and after admission for injury. Few admitted intoxicated drivers are convicted of DUI. Screening and intervention for all intoxicated crash occupants is warranted.
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Affiliation(s)
- C R Schermer
- Department of Surgery, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131, USA
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Marques PR, Tippetts AS, Voas RB, Beirness DJ. Predicting repeat DUI offenses with the alcohol interlock recorder. ACCIDENT; ANALYSIS AND PREVENTION 2001; 33:609-619. [PMID: 11491241 DOI: 10.1016/s0001-4575(00)00074-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The aim of this report has been to use information contained in the alcohol ignition interlock recorder to determine whether systematic analysis of it can be used to predict which DUI offenders will recidivate during the first 2 years after the interlock is removed. The interlock record was accumulated during a 4-year intervention study in Alberta, Canada. Data from more than 5.5 million breath tests collected during interlock use were analyzed retrospectively after allowing repeat DUI offenses to accumulate for up to 2 years post-interlock. The rate of interlock warns at low BAC (0.02-0.04%) and fails at higher BAC ( > 0.04%) were found to be predictive of later repeat DUI. The interlock record was used along with selected driver record variables and questionnaire data to identify predictor sets. CHAID segmentation analysis was used to identify combinations of predictor variables; these were joined with sensitivity analysis to compare different predictor combinations. Several variables, but primarily more prior DUIs and more interlock warns and fails logged during the first 5 months of interlock usage predict greater than 60% of repeat DUI with a false positive rate of less than 10%.
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Affiliation(s)
- P R Marques
- Public Services Research Institute, Pacific Institute for Research and Evaluation (PSRI-PIRE), Calverton, MD 20705-3102, USA.
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Lapham SC, Skipper BJ, Hunt WC, Chang I. Do Risk Factors for Re-Arrest Differ for Female and Male Drunk-Driving Offenders? Alcohol Clin Exp Res 2000. [DOI: 10.1111/j.1530-0277.2000.tb01966.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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C'de Baca J, Lapham SC, Paine S, Skipper BJ. Victim impact panels: who is sentenced to attend? Does attendance affect recidivism of first-time DWI offenders? Alcohol Clin Exp Res 2000; 24:1420-6. [PMID: 11003209 DOI: 10.1111/j.1530-0277.2000.tb02112.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Victim Impact Panels (VIPs) have been implemented widely in the United States by judges as a deterrent to drinking and driving, but there is little evidence of their utility in preventing recidivism. OBJECTIVES The objectives of this study were to examine judges' referral patterns to the VIPs among a multiethnic population of convicted first-time driving while impaired (DWI) offenders and to compare 5-year recidivism rates of those mandated and not mandated to attend the VIP. METHODS Study participants included 5,238 convicted first-time DWI offenders who were referred to a screening program in Bernalillo County, New Mexico, and who completed a personal interview with a master's-level counselor between April 1989 and October 1995. Logistic regression analysis was used to evaluate judges' preferences in mandating offenders to attend a VIP. The percent of subjects reoffending in the 5 years following their referral for screening was calculated by standard life-table analyses. Cox proportional hazards analysis was used to test the effects of known independent predictors for recidivism. Separate models were developed for the entire population, non-Hispanic offenders, and Hispanic/Mexican national subgroups. RESULTS Female judges who regularly adjudicated DWI offenders were more likely to refer offenders to a VIP. Judges were less likely to refer men and offenders with less than 12 years of education and an unknown arrest blood alcohol concentration (BAC), and of Hispanic/Mexican national or other race/ ethnicity. Judges were more likely to refer unmarried offenders to a VIP. After controlling for multiple risk factors, referral to VIP was not a strong predictor of recidivism in Hispanic and non-Hispanic ethnic groups, with 95% confidence limits ranging from 0.8 to 1.0, compared to those not referred. CONCLUSIONS Female judges were more likely than male judges to refer offenders to a VIP, and referral patterns varied by offender characteristics. The VIP referral did not increase rearrest rates but lowered them marginally to not at all. This study should be followed up with a randomized design to control for referral patterns and to further define the impact of mandating offenders to the VIP.
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Affiliation(s)
- J C'de Baca
- Behavioral Health Research Center of the Southwest, Albuquerque, New Mexico 87109, USA.
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